Long ago it was described in California by R,Levine that physical exerciscies increased the liberation of insulin like factors by by the skeletal muscles, but I believe that with the recent findings about  insulin resistance this is also involved due to changes in putative insulin mediators....

see also here:

http://circ.ahajournals.org/content/122/12/1221.full.html

http://www.ncbi.nlm.nih.gov/pubmed/25099941

Really is HIgh Intensity interval training beneficous In TDM? What about LOOK AHEAD(NEJM,JUNE,24-2013)? Yes iit was on overweight or obese diabétics, but with no reduction of cardiovascular events and was not specifically HIT. Others experimental(Journal of Sports Medicine an Physical Fitness, 2014, April, 54: 203-209) account a beneficial effect diminishing glicose levei by decreased insulin resistance-improve HOMA-IR. I find much of us believe in beneficies of adequate amount of exercise in overall fitness with particular effect in TDM. But HIgh intensity interval training is not confidentially with clinical evidence a prescrition to TDM patients. 

Peace and blesses

Continuíng...

Other find heteregenous date and responders and non-responders to HIT in TDM. That firsts improve Insulin resistance, glicose level, blood flow and pressure, endothelial funcition, inflamatóries markers, etc.

(Heterogeneous response... Higgins an cols - Clin Hemorrheol Microcirc, 2014 July, 7 Epub ahead)

Thanks a lot...  RCT by Karstoft et al. (2014) (link sent by Mauricio) says so, that interval training is better. But, 'how' is the main question I would like to explore, please?

How different is that from normal continuous exercise training was my curiosity.

Thank you all anyway, especially for pointing towards appropriate research papers.

The problem with LOOK-AHEAD was the low adherence to the intervention. The same problem as in HF-ACTION. Patients tend to show a low adherence and complience when they shall do their exercise at home. They also exercise not in the intensity levels necessary for beneficial effect. Thats why most of these trials fail to show long term effects.

But still there are a lot of trails going on to increase adherence and complience.

From a glucose perspective, new research by Karstoft and colleagues (JCEM 2014) showed detailed glucose metabolism following a bout. Also, a review by Hawley and Gibala (Diabetologia 2012) talks about the mechanism behind it. A number of studies are showing its effects on AMPK, PGC-1alpha and mitochondrial biogenesis/GLUT4 expression.  

J. P. Little, J. B. Gillen, M. E. Percival et al., “Low-volume high-intensity interval training reduces hyperglycemia and increases muscle mitochondrial capacity in patients with type 2 diabetes,” Journal of Applied Physiology, vol. 111, no. 6, pp. 1554–1560, 2011.

A. Mourier, J.-F. Gautier, E. De Kerviler et al., “Mobilization of visceral adipose tissue related to the improvement in insulin sensitivity in response to physical training in NIDDM: effects of branched-chain amino acid supplements,” Diabetes Care, vol. 20, no. 3, pp. 385–391, 1997

P. Boudou, E. Sobngwi, F. Mauvais-Jarvis, P. Vexiau, and J.-F. Gautier, “Absence of exercise-induced variations in adiponectin levels despite decreased abdominal adiposity and improved insulin sensitivity in type 2 diabetic men,” European Journal of Endocrinology, vol. 149, no. 5, pp. 421–424, 2003

Regarding your question: "How different is that from normal continuous exercise training was my curiosity." This depends on the parameters you are looking at. If you are interested in a general difference between CET and HIT you have to look which parameters they influence and which not and if their is a difference between the two types of exercise.

This is the main issue for you to decide which parameters in type 2 diabetic people you want to look at. For a whole picture you would have to analyse all the different molecular pathways involved in diabetes and to investigate if they are influcenced differently by certain forms of exercise.

Would be so much easier to simply cure the cause of it .........!!!!!!

Available online at www.sciencedirect.com -.., Nutrition ...:;, ScienceDirect Research ELSEVIER Nutrition Research 28 (2008) 137 -143 www.elsevier.corn/locare/nutres

Supplementation of hydrogen-rich water improves lipid and glucose metabolism in patients with type 2 diabetes or impaired glucose tolerance

Sizuo Kajiyama":", Goji Hasegawa":", Mai Asano", Hiroko Hosoda", Michiaki Fukuib, d Naoto Nakamura", Jo Kitawaki", Saeko Imai a . , Koji Nakano", Mitsuhiro Ohta", Tetsuo Adachig, Hiroshi Obayashih, Toshikazu Yoshikawab a

Kajiyama Clinic Kvoto 615-IJIJ35, Japan b Department a/Endocrinology and Metabolism, KI'OIo Prefectural University ofMedicine, Graduate School a/Medical Science. Kyoto 602-8566. Japan C Department of Obstetrics and Gynecology; Kyoto Prefectural University ofMedicine, Graduate School of Medical Science, Kyoto 602-8566. Japan d School of Comprehensive Rehabilitation, Osaka Prefecture University, Osaka 583-8555, Japan e Yamashiro Public Hospital, Kyo/a 619-02 I4. Japan 'Depurnnent of Medical Biochemistry, Kobe Pharmaceutical University (MO), Kobe 658-8566, Japan g Department of Clinical Pharmaceutics. Gifu Pharmaceutical University (TA), Gifu 502-8585, Japan h Institute ofBio-Response Informatics (110), Kyoto 602-0845. Japan Received 5 September 2007; revised 26 December 2007; accepted 17 January 2008

Abstract :  Oxidative stress is recognized widely as being associated with various disorders including diabetes, hypertension, and atherosclerosis. It is well established that hydrogen has a reducing action. We therefore investigated the effects of hydrogen-rich water intake on lipid and glucose metabolism in patients with either type 2 diabetes mellitus (T2DM) or impaired glucose tolerance (lGT). We performed a randomized, double-blind, placebo-controlled, crossover study in 30 patients with T2DM controlled by diet and exercise therapy and 6 patients with KiT. The patients consumed either 900 mUd of hydrogen-rich pure water or 900 mL of placebo pure water tor 8 weeks, with a 12-week washout period. Several biomarkers of oxidative stress, insulin resistance, and glucose metabolism, assessed by an oral glucose tolerance test, were evaluated at baseline and at 8 weeks. Intake of hydrogen-rich water was associated with significant decreases in the levels of modified low-density lipoprotein (LDL) cholesterol (ie, modifications that increase the net negative charge of LDL), small dense LDL. and urinary 8-isoprostanes by 15.5% (P < .01), 5.7~;) (P < .05), and 6.6% (P < .05). respectively,

Hydrogen-rich water intake was also associated with a trend of decreased serum concentrations of oxidized LDL and free fatty acids, and increased plasma levels of adiponectin and extracellular-superoxide dismntase. In 4 of 6 patients with IGT, intake of hydrogen-rich water normalized the oral glucose tolerance test. In conclusion, these results suggest that supplementation with hydrogen-rich water may have a beneficial role in prevention ofT2DM and insulin resistance. @ 2008 Elsevier Inc. All rights reserved. Hydrogen-rich water; Insulin resistance; Type 2 diabetes mellitus; Oxidative stress; Modified LDL; Oxidized LDL; Human Abbreviations: 8MI, body mass index; EC-SOD, extracellular-superoxide disrnutase; ELISA. enzyme-linked immunosorbent assay;emLDL, netelectronegativechargeofmoditiedLDL;ERW,electrolyzed-reducedwater; FBS.fastingblood glucose; HbA Ie , hemoglobin Ale; HDL-C. high-density lipoprotein cholesterol; hsCRP, high-sensitivity C-reactive protein; IGT, impaired glucose tolerance; IRI, immunoreactive insulin: LDL-C, low-density lipoprotein cholesterol; OGlT, oral glucose tolerance test; oxLDL, oxidized LDL; RLP-C, remnant-like particle cholesterol; ROS, reactive oxygen species; sdLDL, small dense LDL; T2DM. type 2 diabetes mellitus; u-lsoP. urinary 8-isoprostane. • Corresponding author. Tel.: +8\ 75251 5505; fax: +81 752523721. E-mail acldress:[email protected] (G. Hasegawa). 0271-5317/$ -see front matter 'I'2008 Elsevier Inc. All rights reserved. doi: 10.1016/j.nutres.2008.01.008 138 S. Kajivama et al. / Nutrition Research 28 (2008) 137-143 1. Introduction with IGT (18 men and 18 women; age, 58.6 ± 4.7 years The prevalence of type 2 diabetes mellitus (T2DM) has increased worldwide and is becoming a major public health problem in many parts of the world [I]. In Japan, it is estimated that nearly 7 million individuals have T20M and that another 7 million have a prediabetic condition [2]. Diet and lifestyle are important risk factors in the development of T2DM [3]. Oxidative stress represents an imbalance between the production of reactive oxygen species (ROS) and the activity of antioxidant defense systems [4]. Oxidative stress IS recognized widely as being associated with various disorders including diabetes, hypertension, and atherosclerosis. Insulin resistance is now receiving increasing attention, not only as a precursor to T20M, but also as a predictor ofincreased risk of cardiovascular disease [5]. It has been reported that antioxidant vitamins such as vitamins C and E have beneficial effects on glycemic control in both humans with T2DM [6,7] and animal models of diabetes [8,9]. Shirahata et al [10] reported that electrolyzed-reduced water (ERW), which has a high pH, high dissolved hydrogen, Jow dissolved oxygen, and extremely negative redox potential values, had the ability to scavenge ROS and therefore protect DNA from oxidative damage. Recently, Kim and Kim reported that administration ofERW improved blood glucose control in animal models of insulin deficiency and insulin resistance [11). However, an antidiabetic effect of ERW in humans has not yet been demonstrated. More recently, Ohsawa et al reported that hydrogen acts as a therapeutic antioxidant by selectively reducing cytotoxic oxygen radicals [12]. These findings led us to consider the possibility that hydrogen-rich water may be useful as a therapeutic supplement. We recently produced hydrogen-rich pure drinking water by dissolving hydrogen in water purified by the following 3 processes: (1) a reverse osmosis/ultrafiltration, (2) an ion-exchange resin, and (3) an ultrafiltration membrane. In the present study, to assess whether supplementation with hydrogen-rich pure water had beneficial effects on the progression of diabetes and insulin resistance in humans, we measured lipid and glucose metabolism and several biomarkers of oxidative stress and insulin resistance, including atherogenic lipoproteins and adipocytokines, in patients with either mild T2DM or impaired glucose tolerance (lGT) after consumption of hydrogen-rich water. The study design was a randomized, double-blind, placebocontrolled crossover trial. 2. Methods and materials 2. J. Subjects The study protocol was approved by the Kyoto Prefectural University of Medicine institutional review board, with informed consent being obtained from all the subjects before enrollment in the study. We recruited 30 patients with T20M controlled by diet and exercise therapy and 6 patients [mean ± SO]; body mass index [8MI], 23.4 ± 3.5 kg/rrr' [mean ± SO]), who fuItiJIed the World Health Organization criteria [13] for diabetes. The patients were enrolled from outpatient clinic of Kajiyama Clinic, Kyoto Prefectural University of Medicine Hospital, and Yamashiro Public Hospital. The exclusion criteria were as follows: (I) known duration of diabetes ~3 years; (2) mean hemoglobin Ale (HbA 1c) level in the past 6 months ~6.9%; (3) serum creatinine concentration ~ I 06 ,umol/L; (4) chronic liver disease or a clinical history and/or signs of cardiovascular disease, cerebrovascular disease, or peripheral arterial disease; (5) heavy smoking and drinking; and (6) use of any dietary and/or antioxidant supplement in the 3 months before the start of the study. Of the 36 patients, 12 patients (33.3%) were receiving a stable dose of antihypertensive medication, whereas 3 patients (8.3%) were receiving a low dose of lipid-lowering medication. No changes were made to these antihypertensive and lipid-lowering therapies during the study. 2.2. Study design The study was a randomized, placebo-controlled, 2 x 8week, double-blind, crossover design with a l2-week washout period. The patients consumed either 900 mUd of hydrogen-rich pure water for 8 weeks or 900 mUd of placebo pure water for 8 weeks, with a 12-week washout period. Both waters were provided in 300 rnL unlabelled aluminum pouches obtained from 1'rom Pharmaceutical Co Ltd (Tokyo, Japan). The following parameters were measured at baseline (0 week) and after 8 weeks: total cholesterol, high-density lipoprotein cholesterol (HOL-C), low-density lipoprotein cholesterol (LOL-C), triacylglycerols, nonesterified fatty acids, glucose, insulin, HbA I c-net electronegative charge of modified LOL (emLDL), oxidized LOL (oxLOL), small dense LOL (sdLOL), remnant-like particle cholesterol (RLP-C), total homocysteine, adiponectin, leptin, resistin, high-sensitivity C-reactive protem (hsCRP), extracellular-superoxide dismutase (EC-SOO), and urinary 8-isoprostane (u-IsoP). In addition, a 75-g oral glucose tolerance test (OGTT) was performed at baseline and after 8 weeks of hydrogen-rich pure water consumption in the 6 patients with IGT. 2.3. Diet and lifestyle All the patients were asked to adhere to a dietary plan tailored to their energy requirements and metabolic control by a registered dietitian and/or physician, using the current Japan Diabetes Society recommendations. The patients recorded their daily dietary intake in a diary by using the calorie and lipid list in the Japan Diabetes Society recommendations guidebook. The dietary diary was collected every week, and the results were reported back to the subjects the following week. In addition, daily activity and physical condition were recorded every 4 weeks using a checklist; and depending on the report, the 139 S. Kajivama et at. I Nutrition Research 28 (2008) /37-/43 physician checked the patient's condition and provided appropriate advice. 2.4. Production of hydrogen-rich pure water Raw water of drinking quality was supplied for the placebo and test waters. The raw water was purified by the following 3 processes: passage through (I) a reverse osmosis/ultrafiltration, (2) an ion-exchange resin, and (3) an ultrafiltration membrane (placebo water: pH 6.9 ± 0.05; electric conductivity 0.7 ± 0.2 }is/em). The rest water was then produced by dissolving hydrogen gas directly into the pure water. The hydrogen-rich pure water had the following physical properties: pH 6.7 ± 0.1, low electric conductivity (0.9 ± 0.2 }is/em), high dissolved hydrogen (1.2 ± 0.1 mg/L), low dissolved oxygen (0.8 ± 0.2 mg/L), and an extremely negative redox potential (-600 ± 20 rnV]. We measured breath hydrogen concentration after the consumption of 300 mL of this hydrogen-rich pure water in 10 healthy, fasting, adult volunteers. Breath hydrogen concentration reached a maximum (56.8 ± 27.8 ppm) at IS minutes and then decreased gradually, returning to baseline levels (11.2 ± 6.5 ppm) after ISO minutes. 2.5. Laboratory investigations Blood and urine samples were obtained in the morning after an overnight fast. Plasma glucose levels were measured by the glucose oxidase method, HbAlc by high-performance liquid chromatography (Arkray Inc, Kyoto, Japan), and serum insulin levels by an immunoradiometric assay (InsulinRIAbead 1/; Abbott Japan, Tokyo, Japan). Serum total cholesterol, IIDL-C, LDL-C, triacylglycerols, and nonesterified fatty acids were measured by enzymatic methods on a chemical autoanalyzer (Hitachi Co, Tokyo, Japan). The emLDL was analyzed by an agarose gel electrophoresis lipoprotein fraction system according to the manufacturer's instructions (Chol/Trig Combo System; Helena Laboratories, Saitama, Japan). The relative proportion of emLOL in the serum samples was calculated on a computer according to the following formula: emLOL density = (b a/a) x 100%, where b is the migration distance of LDL fraction in the test samples and a is the migration distance of normal control sera. The RLP-C was determined by the immune adherence method (Japan lrnmunoresearch Laboratories Co, Ltd, Tokyo, Japan) [14]. The sdLDL was measured in the supernatant that remained after heparinmagnesium precipitation, with lipoproteins with a density

Those are really helpful references for further studies. Thank you so much 

Please see the attached file as an additional reference 

Article Evaluation of antioxidant deficit and lipid profile in type ...

Think about trillions of cells as living units in one human living organism. if one cell is considered as microcosm , and body is macrocosm, we can theorize that whatever is happening in microcosm is the expression of microcosm we observe in our body which is macrocosm. As we all know body is always in survival mode. So when we push the body to extreme physical exhaustion through exercise each living unit (the cell) it will concentrate all its energy to overcome its peril. This is what happening when we push the hitt button to extreme condition of do or die situation , it will try by all means available like better glucose utilization, better working heart and what ever parameters are available. this is nut shell of my understanding of life. think each cell first as life itself secondly as chemical factory just like bullock pull the cart not vice verse. life created this chemical factory. so if science can bring life and its physical body under one umbrella we can strive to live healthy and ultimately happy life. this is dry philosophy if we do not put the missing link of life to chemical factory.thanks for reading this nut shell of my understanding.

The benefits are attached to the interval not the high intensity of the workout. By creating intervals, you are improving oxygen perfusion on a cellular level during the entire workout. You are allowing for built up waste products and metabolites to be removed. You are reducing CO2 buildup and Ph acidity (ketones) from developing. You are reducing injury on a microscopic level that would occur in circuit or Crossfit type workouts.

"Intervals are the new sitting" (LOL)